Healthcare Provider Details

I. General information

NPI: 1427176171
Provider Name (Legal Business Name): GUZZETTI OPTOMETRIC SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 STATE AVE
BEAVER PA
15009-1728
US

IV. Provider business mailing address

212 STATE AVE
BEAVER PA
15009-1728
US

V. Phone/Fax

Practice location:
  • Phone: 724-774-7559
  • Fax: 724-774-6557
Mailing address:
  • Phone: 724-774-7559
  • Fax: 724-774-6557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOEG001533
License Number StatePA

VIII. Authorized Official

Name: JOHN A. GUZZETTI
Title or Position: PRESIDENT
Credential: O.D.
Phone: 724-774-7559